Clinical Observation Of Ultrasound-guided Cervical Nerve Root And Stellate Ganglion Block Combined With Medical Administration For The Treatment Of Postherpetic Neuralgia

Objective: To evaluate the efficacy and safety of ultrasound-guided cervical nerve root block and stellate ganglion block combined with medical administration on the treatment of postherpetic neuralgia(PHN).Methods: Sixty patients diagnosed with PHN in head,neck and upper limbs were randomly divided into two groups: control group(group C,n=30): ultrasound-guided stellate ganglion block combined with medical administration,test group(group S,n=30): ultrasound-guided cervical nerve root and stellate ganglion block combined with medical administration.Inclusion criteria: 1.Natural course of disease 1 ~ 6 months;2.Lesion involvement range C2-C7 nerve distribution area,the skin herpes in the lesion area has faded and healed,but the remaining pigmentation or mild scar,accompanied by burning,needling and other neuropathic pain,abnormal nerve sensation;3.Able to correctly assess the state and degree of pain,visual analogue scale(VAS)score ?6 points;4.Willing to comply with the assigned treatment and Follow-up evaluation.Exclusion criteria: 1.Previous intracranial space occupying lesions;2.Abnormal immune function or need immunosuppressive therapy;3.The puncture site has infection or acute systemic infection;4.Severe cardiopulmonary insufficiency,liver and kidney insufficiency or other serious systemic diseases;5.Pregnancy or lactation;6.Abnormal coagulation function;7.Diabetic patients with poor blood sugar control;8.Patients with mental illness;9.Patients with drug allergy or other inappropriate nerve block in this study.The curative effect was evaluated with visual analogue scale(VAS),selfrating scale of sleep(SRSS)and self-rating depression scale(SDS)at the time of pretreatment,1 week,4 weeks and 3 months after the treatment.And assessing the safety of nerve block therapy.Results: The VAS,SRSS,and SDS scores were different at different time points before and after treatment(P < 0.05);VAS,SRSS and SDS scores of the test group were different from those of the control group,and VAS,SRSS and SDS scores of the test group were lower than those of the control group(P < 0.05).The variation trend of VAS,SRSS and SDS scores was different between the test group and the control group(P < 0.05).Only hoarseness and mild dizziness appeared in the two groups,with no significant difference.The adverse effects had no significant difference in both groups.Conclusion: Ultrasound-guided cervical nerve root and stellate ganglion block combined with medical administration can effectively alleviate pain in patients with PHN,which is a minimally invasive and safe treatment method and has clinical application prospect..